| Abstract |
BACKGROUND:
Although dyslipidemia and hypertension occur together more often than
can be explained by chance, few studies have carefully explored the nature
of the relationship between plasma lipid levels and the risk of developing
hypertension.
METHODS: We conducted a prospective study of 16 130 middle-aged and older
female health professionals in 1992 who provided baseline blood samples
and had no history of high cholesterol level (no treatment or diagnosis)
or hypertension (no treatment, diagnosis, or elevated blood pressure).
Plasma lipid levels were measured, and baseline risk factors were collected.
Incident hypertension included a new physician diagnosis, the initiation
of antihypertensive treatment, systolic blood pressure of 140 mm Hg or
greater, or diastolic blood pressure of 90 mm Hg or greater.
RESULTS: During 10.8 years of follow-up, incident hypertension developed
in 4593 women. In multivariate-adjusted models, the relative risks of
development of hypertension from the lowest (referent) to the highest
quintile of baseline total cholesterol level were 1.00, 0.96, 1.02, 1.09,
and 1.12 (P = .002 for trend); for low-density lipoprotein cholesterol
level, 1.00, 0.97, 1.00, 1.02, and 1.11 (P = .053 for trend); for high-density
lipoprotein cholesterol level, 1.00, 0.93, 0.87, 0.87, and 0.81 (P <
.001 for trend); for non-high-density lipoprotein cholesterol level, 1.00,
1.06, 1.11, 1.12, and 1.25 (P < .001 for trend); and for the ratio
of total to high-density cholesterol, 1.00, 1.10, 1.14, 1.20, and 1.34
(P < .001 for trend). Similar relative risks were noted for Adult Treatment
Panel III clinical cut points and after the exclusion of obese or diabetic
women.
CONCLUSION: In this large prospective cohort, atherogenic dyslipidemias
were associated with the subsequent development of hypertension among
healthy women.
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